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Boulder County officials praise surgeon general's advisory for more people to carry naloxone

Local officials struggle with keeping supply of medication that can reverse opioid overdoses

By Madeline St. Amour

Staff Writer

Posted:
04/05/2018 07:35:29 PM MDT

Updated:
04/06/2018 07:18:53 AM MDT

Rob Bellamy, a harm reduction specialist with Boulder County Public Health, demonstrates how to set up a proper body position to administer Narcan to a person who might be suffering an opioid overdose during a presentation in February at the University of Colorado's Boulder campus. (Paul Aiken / Staff Photographer)

Eighteen months ago, the owners of Alfalfa's Market agreed to keep naloxone in their stores for emergencies.

Two overdoses at the Boulder location spurred the decision, according to Ted Bradshaw, human resources director for the organic market that has stores in Boulder and Louisville.

"Both were young men who were customers," he said. "They were discovered overdosed in the public men's bathroom by other customers."

Bradshaw, a former law enforcement officer in Boulder County, had seen overdoses before, but it was "very difficult for other people, and certainly for guests, to witness that."

In both instances, 911 was called and emergency responders were able to save the men with naloxone, a medication that can reverse opioid overdoses.

After the second incident, the three owners of Alfalfa's — Mark Homlish, Tripp Wall and Mike Corenblat — decided to keep the often lifesaving drug in stores and provide training to senior employees.

Not long after their decision, a federal advisory is now saying more people should be carrying naloxone.

U.S. Surgeon General Jerome M. Adams issued the first advisory to come from the office in 13 years Thursday morning. He's urging more people close to the opioid epidemic — those using opiates illicitly or as prescribed, their family and friends, health care practitioners and anyone else who often comes in contact with those at risk — to carry naloxone.

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Most emergency responders already carry the medication, but it must be administered quickly. More than half of opioid overdose deaths happen at home, he said in a news release.

Local health organizations say this is a step in the right direction, though there's still more work to do to combat the epidemic that took 959 lives in Colorado in 2017, according to preliminary data from a statewide nonprofit.

"We are thrilled with the Surgeon General's advisory on naloxone," said Jamie Feld, an epidemiologist at Boulder County Public Health. "Access to naloxone has been a key component of reduction" in opioid overdose deaths in the county.

But, while the number of drug overdose deaths in general are down in Boulder County from 54 in 2013 to 39 in 2016, according to a new report from the Colorado Health Institute, the number of overdose deaths involving heroin has increased, Feld said.

There's also a greater need for services as the opioid epidemic outpaced available government funding. While Boulder County has a robust syringe access program — more than 1,700 people used the service in 2017 — naloxone kits run out fast.

Naloxone, an antagonist medication, stops overdoses by knocking "opiates off of the (opioid) receptors" in the brain, said Ann Noonan, director of SUD Center of Excellence at Mental Health Partners, a nonprofit community mental health center in Boulder.

Even if the person isn't experiencing an opioid overdose, a dose of naloxone won't harm them.

The kits are handed out at the four syringe access sites and are meant to serve those most in need who can't get them through health insurance. Boulder County Public Health uses a mobile app called OpiRescue, which also calls 911 and gives instructions for how to use naloxone, to track how many lives have been saved by people using those kits. Since 2013, there have been 123 overdose reversals reported on the app.

The program was down to two kits from the 565 Boulder received this past year, Noonan said, but leftover money in the state fund was used to purchase more kits, sending the county 200 more until a new shipment arrives in April or May.

The Longmont Police Department, which has all officers carry naloxone, also faces an unsure future with its supply. While Deputy Chief Jeff Satur was able to get more doses from the state Attorney General's Office before their current kits expire in June, he doesn't know where the next batch will come from.

"Worst-case scenario, we'd have to buy it," he said. "Our budget is not unlimited," but the cost for 200 doses would come out to about $7,500.

"We'd find the money somewhere," he said.

While the current money paying for the kits and other programs is helpful, Noonan said providers and law enforcement need more consistency.

"That will only happen when we stop having grants funding services," she said, describing the infrastructure of substance abuse treatment as "fragile."

A benefit of naloxone is that it can be bought in pharmacies across the nation, and most insurers cover it, Noonan said, including Medicaid. While the brand-name Narcan kit is more than $100, she said, a generic injection of naloxone runs about $25 and a nasal kit is a little less than $30.

Noonan was also happy to hear about the new advisory, she said, as it will start a conversation, if nothing else.

"It's my feeling that we should be training people on how to use naloxone at the same time and in the same way we train people to use CPR," she said.

Noonan hopes those who object to using naloxone can think about it as "an opportunity for somebody to live another day to choose recovery."

Satur also supports the new advisory.

While on a flight coming from Tennessee, a man next to Satur had a number of opioid prescriptions, so Satur asked if he kept naloxone handy.

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